Ablative procedures of the prostate rarely miss clinically significant prostate cancer (PCa) in patients whose PSA levels are below 4 ng/mL, a recent study suggests.
Using the Surveillance, Epidemiology and End Results (SEER) database, Joshua J. Meeks, MD, and colleagues at Memorial Sloan-Kettering Cancer Center in New York identified 74,505 men diagnosed with stage T1 PCa from 2004-2006. They calculated the total number of laser vaporizations and transurethral resections of the prostate (TURPs) based on Medicare claims for the same three-year period.
If PSA screening was used uniformly—excluding men with PSA levels above 4—only one of 382 TURPs would identify clinically significant PCa, for a total of 390 in the American population in three years, according to an online report in The Journal of Urology. Based on Medicare reported laser vaporization use, only 163 clinically significant PCa tumors would be missed in more than 60,000 procedures.
The investigators defined clinically significant PCa as Gleason 7 or greater tumors in men 40-75 years old.